Individual
DAVID PROULX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
140 WORCESTER ST, SUITE 9, WEST BOYLSTON, MA 01583-1765
(508) 963-0014
Mailing address
PO BOX 173, GROSVENOR DALE, CT 06246-0173
(508) 963-0014
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9477
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9477
MASSAGE THERAPIST
MA
Enumeration date
10/17/2011
Last updated
10/17/2011
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